The patient's medication access journey: a conceptual framework focused beyond adherence.

Area of Science:

• Health Services Research
• Pharmaceutical Policy
• Patient Access to Medications

Background:

• Medication accessibility is crucial for reducing morbidity and mortality, yet many Americans face significant challenges.
• Existing healthcare access frameworks do not specifically address the complexities of medication access.
• A deeper understanding of medication access beyond adherence is needed to identify improvement opportunities.

Purpose of the Study:

• To develop a comprehensive conceptual framework for medication access.
• To define the patient's medication access journey.
• To identify and characterize common barriers encountered during medication access.

Main Methods:

• Convened a 15-expert multistakeholder roundtable by the Pharmacy Quality Alliance in 2018.
• Conducted two literature reviews and an environmental scan to identify barriers and interventions.
• Developed a conceptual framework based on expert input and literature findings.

Main Results:

• The developed framework includes 7 key patient access nodes: perceived need, help seeking, encounter, prescribing, prescription adjudication, prescription dispensing, and adherence.
• Identified 18 distinct barriers to medication access.
• Predominant barriers across multiple nodes included patient health literacy, cost, insurance, and organizational health literacy.

Conclusions:

• The new framework offers a patient-centered, holistic perspective on medication access.
• It integrates critical access points and associated barriers.
• Provides a structured approach for developing interventions and quality measures to address medication access challenges.